Referring a MAC Scheme claimant for treatment
The referring doctor or specialist should clearly document the reasons for treatment and rehabilitation in a medical certificate, report or referral letter. This will assist TIO MAC when assessing whether the proposed treatment or rehabilitation are covered by the MAC Scheme.
After receiving a claimant referral, the treatment provider should contact the claimant's TIO MAC case manager. The case manager will review the MAC claims status and advise if MAC will fund the proposed treatment. If the patient’s MAC claim is still pending a decision or has been denied, MAC may be unable to pay for any treatment services.
Am I the right provider for this referral?
If you are unable to treat the claimant or think that they should have been referred to a different service provider, please contact TIO MAC, to discuss the matter with the claimant's Case Manager.
Choice of provider
A MAC Scheme claimant has the right to choose their treatment provider or change providers at any time.
If for any reason you are not able to provide treatment, then you should either refer the claimant to an alternative provider or facilitate another referral from their treating doctor.
Please inform the patient’s TIO MAC case manager if you have received a new referral or are referring the claimant elsewhere.
Related information
MAC Scheme
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